Precautions and warnings

When giving glucose solutions to diabetic or prediabetic individuals to deliver calories, more caution is required. It is preferable to monitor blood and urine glucose and, if necessary, inject insulin to manage and reduce probable hyperglycemia and glycosuria.

Tetracycline may diminish the nitrogen sparing effects of injected amino acids due to its antianabolic activity.

In individuals with a history of renal disease, pulmonary disease, or cardiac failure, feeding regimens including amino acids should be used with caution to avoid excessive fluid accumulation.

In patients with reduced renal function, nitrogen intake should be closely managed.

Contraindications

Patients with hepatic coma or metabolic diseases causing poor nitrogen use should not take this medication.

Mode of actions

A crystalline amino acid solution contains crystalline amino acids that help to increase protein synthesis and wound healing while also lowering endogenous protein catabolism. Total parenteral nutrition consists of amino acids delivered via central venous infusion in combination with concentrated dextrose, electrolytes, vitamins, trace metals, and auxiliary fat supplements (TPN). Amino acids can also be given through the veins, along with dextrose and electrolytes for maintenance.

Dosage & Administration

For peripheral intravenous infusion, 1 to 1.5 g/kg/day of total amino acids will reduce protein catabolism. Infusion or ingestion of carbohydrate or lipid will not reduce the nitrogen sparing effect of intravenous amino acid infusions at this dose.
As with all intravenous fluid therapy, the primary aim is to provide sufficient water to compensate for insensible, urinary, and other fluid losses (nasogastric suction, fistula drainage, and diarrhea). Infused at a rate of 45 mL/kg/day, will meet the fluid and amino acid requirements of the stable adult patient.
As reported in the literature, the dosage and constant infusion rate of intravenous dextrose must be selected with caution in pediatric patients, particularly neonates and low birth weight infants, because of the increased risk of hyperglycemia/hypoglycemia.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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